Effective Programs for Treating Autism Spectrum Disorder: Applied Behavior Analysis Models

299 Pages·2010·1.8 MB·English

by  Betty Fry Williams

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E ective Programs for Treating
Autism Spectrum Disorder
Effective Programs for Treating Autism Spectrum Disorder: Applied Behavior
Analysis Models is written for teachers, parents, and the many service providers
who work with individuals with autism spectrum disorder (ASD). Part I
reviews the characteristics of ASD, summarizes major theories and research
findings regarding cause(s) of ASD, and discusses the most popular treatment
claims, examining each approach’s scientific base and value. Part II provides an
informative overview of applied behavior analysis, focusing on the principles
of learning and basic procedures based upon those principles. These two parts
provide a foundation for understanding the strategies implemented by the
outstanding treatment programs described in Part III.
The eight models described in Part III represent the state-of-the-art in
terms of comprehensive, evidence-based programs for the treatment of per-
sons with ASD, from infancy through adulthood. Programs reviewed include
the Lovaas Institute, Koegel Center, Strategic Teaching and Reinforcement
Systems (STARS), Project DATA, New England Children’s Center, May Insti-
tute, Princeton Child Development Institute, and Judge Rotenberg Center.
Strategies explained include intensive early behavioral intervention, Pivotal
Response Training, verbal behavior, script fading, social stories, visual activity
schedules, functional analysis, the Picture Exchange Communication System,
and the Family-Teaching Model. Key features of this unique new book include:
Multiple Treatment Models – Unlike most other books in this field which
focus on a single approach to treatment, this one provides an overview and
comparison of many successful approaches.
Common Chapter Structure – Each Part III chapter follows a common struc-
ture: historical background and program description, distinguishing features,
quality control, and research and replication. Program descriptions include
definitions, summaries of recent developments, and future trends. References
and resources permit further study and examples illustrate applications.
Program Descriptions – Each of the centers was personally visited by the
authors, who conducted in-depth interviews with founders and/or key
personnel.
Evidence-Based Presentations – Summaries of promising research findings
on the characteristics and causes of ASD are brought together with cautions
about extrapolating from scientific research.
Betty Fry Williams, Ph.D., is Coordinator of the Special Education program
at Whitworth University, is the university’s current Edward B. Lindaman Chair,
researching issues in the identification and treatment of autism spectrum
disorder.
Randy Lee Williams, Ph.D., is a professor in the Department of Special
Education at Gonzaga University, specializing in teaching applied behavior
analysis and Direct Instruction to university students training to become
special education teachers.
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E ective Programs for Treating
Autism Spectrum Disorder
Applied Behavior Analysis Models
Betty Fry Williams
Whitworth University
Randy Lee Williams
Gonzaga University
First published 2011
by Routledge
270 Madison Avenue, New York, NY 10016
Simultaneously published in the UK
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa business
This edition published in the Taylor & Francis e-Library, 2010.
To purchase your own copy of this or any of Taylor & Francis or Routledge’s
collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.
© 2011 Taylor & Francis
The right of Betty Fry Williams and Randy Lee Williams to be identified as
authors of this work has been asserted by them in accordance with sections
77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or
reproduced or utilized in any form or by any electronic,
mechanical or other means, now known or hereafter
invented, including photocopying and recording, or in any
information storage or retrieval system, without permission in
writing from the publishers.
Cover photo: Josh Finkel and Amy Finkel.
Cover photo © Randy L. Williams.
Trademark Notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and explanation
without intent to infringe.
Library of Congress Cataloging-in-Publication Data
Williams, Betty Fry.
Effective programs for treating autism spectrum disorder : applied
behavior analysis models / Betty Fry Williams, Randy Lee Williams.
p. ; cm.
Includes bibliographical references and index.
1. Autism spectrum disorders–Treatment. 2. Behavioral assessment.
I. Williams, Randy Lee. II. Title.
[DNLM: 1. Child Development Disorders, Pervasive–therapy–United
States. 2. Behavior Therapy–methods–United States. 3. Child–United
States. 4. Models, Educational–United States. 5. Program Evaluation–
United States. WS 350.6 W721e 2010]
RC553.A88W545 2010
362.196′85882—dc22 2010000410
ISBN 0-203-85503-5 Master e-book ISBN
ISBN13: 978–0–415–99931–1 (hbk)
ISBN13: 978–0–415–99932–8 (pbk)
ISBN13: 978–0–203–85503–4 (ebk)
Dedication
This book is dedicated to the memory of our dear friend and mentor, James H.
Kaye (1942–2009), the founder of the Kalamazoo Valley Multihandicap Center,
now known as the Croyden Avenue School. Jim gave so many of us, who are
active in the field today, the opportunity to try our wings as we applied
behavioral science to the emerging discipline of special education.

Contents
Preface xvii
Acknowledgments xxi
PART I: AUTISM SPECTRUM DISORDER 1
1 CHARACTERISTICS OF AUTISM SPECTRUM
DISORDER 3
History 4
Diagnosis of Autism Spectrum Disorder 6
Characteristics 9
Social Interaction 9
Language Development 10
Repetitive Behaviors and Limited Interests 10
Other Features 11
Cognitive Differences 11
Response to Environmental Stimuli 12
Adaptive Behavior Deficits 12
Savant Syndrome 13
Increased Mortality Rate 13
Accompanying Disorders 14
Seizure Disorders 14
Psychiatric Disorders 14
Sleep Disorders 15
Eating Disorders 15
Behavior Disorders 16
Prevalence 17
Cautionary Remarks 18
2 SEARCHING FOR THE CAUSE OF AUTISM
SPECTRUM DISORDER 19
Primary Research Routes 22
Evidence Relating to Neuropathology 23
Research Findings on Brain Structure 23
Cautions Regarding Evidence in Brain Structure 24
Research Findings on Brain Function 24
Seizures and Autism Spectrum Disorder 25
vii
viii (cid:127) Contents
Underconnectivity 25
Serotonin Abnormalities 26
Cautions Regarding Brain Function Evidence 26
Conclusions Regarding Neuropathology 28
The Opioid Excess Theory 28
Evidence Implicating Opioid Excess 28
Evidence for Diets Eliminating Gluten and Casein 29
Cautions and Conclusions Regarding Diets Eliminating
Gluten and Casein 30
Evidence Regarding Vaccinations 31
Cautions Regarding Evidence on Vaccines 31
Conclusions Regarding Vaccinations as a Cause of Autism 33
Evidence Regarding Immune Reactions 33
Cautions and Conclusions Regarding Immune Responses 35
Conclusions Regarding the Opioid Excess Theory 35
Genetic Inheritance 35
Chromosome Abnormalities 36
Candidate Genes 37
Inheritance Patterns 37
Recessive Inheritance 38
Dominant Inheritance 38
Complications of Inheritance 38
Sex-Linked Inheritance 38
Spontaneous Germ-Line Mutation 39
Evidence Regarding Genetic Inheritance of Autism 39
Twin Studies 39
Environmental Factors 40
Timing of Environmental Impact 40
Research on Candidate Genes 41
Cautions Regarding Genetic Inheritance 41
Conclusions Regarding Genetic Inheritance 42
3 EXAMINING THE EVIDENCE FOR TREATMENT
OF AUTISM SPECTRUM DISORDER 43
Evidence-Based Practice 44
Group Research Designs 45
Single-Subject Research Designs 46
Scientifically Based Treatment 48
Promising Practice 48
Limited Supporting Information 48
Not Recommended 48
Categories of Treatment 48
Nutritional—Biologically-Based Treatment 49
Contents (cid:127) ix
Relational—Socially/Psychologically-Based Treatment 49
Sensory/Neural—Brain-Based Treatment 49
Pharmacological—Medically-Based Treatment 50
Educational/Behavioral—Skill-Based Treatment 50
Nutritional—Biologically-Based Treatment 50
Gluten-Free and Casein-Free Diets—Limited Supporting
Information 50
Vitamin Therapy—Limited Supporting Information 51
Relational—Socially-Based Treatment 52
DIR®/Floortime—Limited Supporting Information 52
The Son-Rise Program or Option Method—Limited
Supporting Information 52
Gentle Teaching—Limited Supporting Information 53
Holding Therapy—Not Recommended 53
Sensory/Neural—Brain-Based Treatment 54
Sensory Integration—Limited Supporting Information 54
Vision Therapy—Limited Supporting Information 54
Auditory Integration—Limited Supporting Information 55
Art Therapy—Limited Supporting Information 55
Music Therapy—Limited Supporting Information 56
Facilitated Communication—Not Recommended 56
Pharmacological—Medically-Based Treatment 56
Amphetamines—Limited Supporting Information 57
Antipsychotics—Benzodiazepines—Limited Supporting
Information 57
Antidepressants—Limited Supporting Information 58
Secretin—Not Recommended 58
Chelation—Not Recommended 58
Educational/Behavioral—Skill-Based Treatment 59
Treatment of Autistic and Related Communication-
Handicapped Children—Promising Practice 59
Learning Experiences: An Alternative Program for Preschoolers
and Parents—Promising Practice 60
Applied Behavior Analysis Programs—Promising Practices and
Scientifically Based Treatment 60
PART II: APPLIED BEHAVIOR ANALYSIS 63
4 PRINCIPLES OF APPLIED BEHAVIOR ANALYSIS 65
Historical Overview of Applied Behavior Analysis 65
Applied Behavior Analysis 67
Applied 68
Behavioral 68